Search for: "Administrator for the Centers for Medicare and Medicaid Services"
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27 Jan 2020, 11:20 am
Medicare fraud can occur anywhere As long as there exists a financial incentive for doctors and healthcare administrators to fraudulently charge for services they never rendered, or falsely inflate the cost of services to receive more money from the government, Medicare and Medicaid fraud will unfortunately continue to happen. [read post]
25 Oct 2021, 6:03 am
The federal agency that oversees Medicare, the Centers for Medicare & Medicaid Services (CMS), performs few audits itself, but outsources these duties to a series of independent contractors, such as Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), and the Supplemental Medical Review Contractor (SRMC). [read post]
18 Dec 2020, 5:21 am
The Centers for Medicaid & Medicare Services (CMS) recently released the 2021 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule, which may be accessed here. [read post]
22 Jun 2016, 10:59 am
On June 23, 2016, the Centers for Medicare & Medicaid Services (CMS) is publishing a major final rule to base Medicare clinical laboratory fee schedule (CLFS) reimbursement on private insurance payment amounts, as required by the Protecting Access to Medicare Act of 2014 (PAMA). [read post]
4 Sep 2020, 12:30 pm
On September 1, 2020, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that would establish a new Medicare coverage pathway, Medicare Coverage of Innovative Technology (“MCIT”), for medical devices that are designated by the Food and Drug Administration (“FDA”) as breakthrough devices. [read post]
5 Nov 2018, 3:06 pm
The Centers for Medicare & Medicaid Services’ (CMS) final calendar year 2019 Medicare home health prospective payment system (HH PPS) rule boosts rates by 2.2% next year and ushers in broader case-mix methodology reforms for 2020. [read post]
16 Aug 2012, 5:55 am
Nursing home operators like Skilled Healthcare Group (SKH) and Sun Healthcare Group (SUNH) are likely to be the primary beneficiaries of next year's rate boost, which the Centers for Medicare & Medicaid Services estimates could add up to around $670M. [read post]
15 Sep 2020, 7:04 am
On Monday, September 14, 2020, the Centers for Medicare & Medicaid Services (“CMS”) Administrator Seema Verma announced on Twitter that CMS was withdrawing the proposed Medicaid Fiscal Accountability Rule (“MFAR”) from its regulatory agenda. [read post]
17 Nov 2023, 5:26 am
The Centers for Medicare & Medicaid Services (CMS) has published its final rule that requires nursing homes enrolled in Medicare and Medicaid to disclose additional ownership and management information to CMS and state Medicaid agencies. [read post]
14 Aug 2018, 12:35 pm
The Centers for Medicare & Medicaid Services (CMS) has released its final rule updating the Medicare inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2019. [read post]
3 Aug 2015, 1:30 am
" King introduced his bill in response to the July 8 announcement by the Centers for Medicare and Medicaid Services (CMS) to pay doctors to counsel patients about end-of-life care. [read post]
18 Jan 2017, 10:25 am
CMS has finalized extensive changes to the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid programs. [read post]
22 Apr 2021, 8:47 am
In response, the Centers for Medicare & Medicaid Services (“CMS”) issued guidance that Medicare fee-for-service (“FFS”) claims with dates of service after April 1, 2013 would incur a 2% reduction in Medicare payment. [read post]
10 Sep 2021, 5:55 am
As part of the 2022 Medicare Physician Fee Schedule Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) has proposed to significantly expand its authority to deny or revoke a provider’s or supplier’s Medicare billing privileges. [read post]
2 Nov 2022, 5:00 am
As many healthcare providers may know, UPICs are the primary program integrity contractors for the Centers for Medicare & Medicaid Services (CMS) and the only program integrity contractors with authority to review both Medicare and Medicaid claims. [read post]
16 Dec 2020, 8:32 am
On Tuesday, December 1, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Physician Fee Schedule (PFS) final rule, confirming an expansion to telehealth coverage and the scope of non-physician providers. [read post]
31 Aug 2023, 1:02 pm
On August 28, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final payment rule for inpatient and long-term care hospitals (“LTCH”) that builds on the Biden-Harris Administration’s priorities to provide support to historically underserved and under-resourced communities and to promote the highest quality outcomes and safest care for all individuals. [read post]
28 Jul 2017, 6:30 am
Medicare Set Aside Compliance – Medicare is Taking Action As the Centers for Medicare and Medicaid Services (“CMS” or “Medicare”) ratchet up their active monitoring of Medicare Set Aside (“MSA”) accounts, using a professional administrator to help make sure reporting is in order is becoming even more critical. [read post]
15 Mar 2023, 5:00 am
Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule to implement requirements of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). [read post]
17 Mar 2020, 6:55 pm
Effective retroactively to March 6, 2020, the Centers for Medicare & Medicaid Services (CMS) will allow providers to bill Medicare for a range of telehealth services. [read post]
